988: A New Chapter in America’s Fight Against Suicide

By Ajit Pai

If someone were to ask you right now the phone number for the National Suicide Prevention Lifeline, would you know the answer? That number can be hard to remember: 1-800-273-TALK (or 1-800-273-8255). But on July 16, 2022, this will change: 988 will become active across the United States as a three-digit number for suicide prevention and mental health support. Calls to 988 will be directed to the nearest Lifeline center, where trained counselors will be able to help those struggling with thoughts of suicide and other mental health issues.

The yellow ribbon symbolic of suicide prevention, via Reuters

This is a major milestone in mental health—one that comes none too soon for those who need help. In 2020, the most recent year for which we have statistics, we lost almost 46,000 of our fellow Americans to suicide. That’s almost one death every 11 minutes. The suicide rate has increased dramatically over the years, with an increase of over one-third since 1999. In fact, suicide rates today are the highest the United States has seen since World War II. (The American Foundation for Suicide Prevention reports that there were 1.2 million suicide attempts in 2020.) Many believe all these factors may have gotten worse in the wake of the COVID-19 pandemic, during which millions were isolated and in-person treatment became more challenging.

Certain populations are particularly at risk. For instance, the suicide rate for veterans is about 1.5 times higher than that of the general population, with almost two dozen veterans dying by suicide every day. The suicide rate has increased dramatically since 2007, with suicide now the second most common cause of death for teenagers and young adults. In particular, young LGBT individuals contemplate suicide at a rate over four times higher than their heterosexual counterparts.

For many years, the folks at the National Suicide Prevention Lifeline have worked tirelessly to help address these challenges. The Lifeline is a national network of more than 200 local- and state-funded crisis centers that handle calls to the number 1-800-273-TALK. The Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) administers the Lifeline in partnership with the Department of Veterans Affairs (VA), which manages the Veterans Crisis Line. Calls to the Lifeline from anywhere in the United States are routed to the closest certified local crisis centers according to the caller’s area code. The Lifeline’s trained counselors do heroic work helping those who are struggling; a few years ago at a center in Toledo, Ohio, I personally heard from these counselors how often they save lives—when someone reaches out.

But in recognition of the need for a more seamless connection between individuals in crisis and counselors, Congress in 2018 passed the Suicide Hotline Improvement Act. The act directed the Federal Communications Commission (FCC) to coordinate with SAMHSA and the VA to assess the Lifeline’s effectiveness and determine the feasibility of a simple, easy-to-remember, three-digit dialing code to be used for a national suicide prevention and mental health crisis hotline system. In 2019, the FCC issued a report pursuant to the act, recommending the use of 988 as the three-digit code best suited for the National Suicide Prevention Lifeline. On July 16, 2020, the FCC adopted rules designating this new phone number for individuals in crisis to connect with the Lifeline and requiring phone companies to reconfigure their networks by July 16, 2022, to direct all calls to 988 to the Lifeline. And in 2021, the FCC extended this requirement to cover text messages.

The bottom line of all this work: On
July 16, 2022, phone calls and text messages to 988 will be routed directly to
the National Suicide Prevention Lifeline.

This will be transformational for
millions of Americans. Nationwide availability of 988 will save lives by
enabling more people who are struggling to connect with those who can help. It
is much easier to remember 988 than an 11-digit number, which means more
Americans will contact the Lifeline and get potentially life-saving counsel. And
because 988 has an echo of 911—the emergency number that virtually every
American knows—988 could well become a commonly understood number, just as 911
is today. Additionally, the full implementation of 988 will help mitigate any
stigma associated with seeking and getting help for mental health. To be sure,
challenges will remain—among them, ensuring that Lifeline centers have
sufficient staffing and resources and that counselors will be able to handle
text messages as adeptly as they do phone calls. But recent history gives us
hope that policymakers and regulators will tackle these challenges thoughtfully
and in a bipartisan manner.

988’s full activation on July 16,
2022, represents a cardinal moment in America’s approach to mental health. The
number sends a simple but powerful message to Americans: You are not alone.

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